Patience, Persistence and Pragmatism: Experiences and Lessons Learnt from the Implementation of Clinically Integrated Teaching and Learning of Evidence-Based Health Care - A Qualitative Study

Background

Clinically integrated teaching and learning are regarded as the best options for improving evidence-based healthcare (EBHC) knowledge, skills and attitudes. To inform implementation of such strategies, we assessed experiences and opinions on lessons learnt of those involved in such programmes.

Methods and Findings

We conducted semi-structured interviews with 24 EBHC programme coordinators from around the world, selected through purposive sampling. Following data transcription, a multidisciplinary group of investigators carried out analysis and data interpretation, using thematic content analysis. Successful implementation of clinically integrated teaching and learning of EBHC takes much time. Student learning needs to start in pre-clinical years with consolidation, application and assessment following in clinical years. Learning is supported through partnerships between various types of staff including the core EBHC team, clinical lecturers and clinicians working in the clinical setting. While full integration of EBHC learning into all clinical rotations is considered necessary, this was not always achieved. Critical success factors were pragmatism and readiness to use opportunities for engagement and including EBHC learning in the curriculum; patience; and a critical mass of the right teachers who have EBHC knowledge and skills and are confident in facilitating learning. Role modelling of EBHC within the clinical setting emerged as an important facilitator. The institutional context exerts an important influence; with faculty buy-in, endorsement by institutional leaders, and an EBHC-friendly culture, together with a supportive community of practice, all acting as key enablers. The most common challenges identified were lack of teaching time within the clinical curriculum, misconceptions about EBHC, resistance of staff, lack of confidence of tutors, lack of time, and negative role modelling.

Conclusions

Implementing clinically integrated EBHC curricula requires institutional support, a critical mass of the right teachers and role models in the clinical setting combined with patience, persistence and pragmatism on the part of teachers.

Experimental investigation of flow and segregation behaviour of bulk solids in silos under high gravity conditions

Many researchers have investigated the flow and segregation behaviour in model scale experimental silos at normal gravity conditions. However it is known that the stresses experienced by the bulk solid in industrial silos are high when compared to model silos. Therefore it is important to understand the effect of stress level on flow and segregation behaviour and establish the scaling laws governing this behaviour. The objective of this paper is to understand the effect of gravity on the flow and segregation behaviour of bulk solids in a silo centrifuge model. The materials used were two mixtures composed of Polyamide and glass beads. The discharge of two bi-disperse bulk solids in a silo centrifuge model were recorded under accelerations ranging from 1g to 15g. The velocity distribution during discharge was evaluated using Particle Image Velocimetry (PIV) techniques and the concentration distribution of large and small particles were obtained by imaging processing techniques. The flow and segregation behaviour at high gravities were then quantified and compared with the empirical equations available in the literature.

Experimental and discrete element modelling of cohesive iron ore fines

In this study, the behaviour of iron ore fines with varying levels of adhesion was investigated using a confined compression test and a uniaxial test. The uniaxial test was conducted using the semi-automated uniaxial EPT tester in which the cohesive strength of a bulk solid is evaluated from an unconfined compression test following a period of consolidation to a pre-defined vertical stress. The iron ore fines were also tested by measuring both the vertical and circumferential strains on the cylindrical container walls under vertical loading in a separate confined compression tester - the K0 tester, to determine the lateral pressure ratio. Discrete Element Method simulations of both experiments were carried out and the predictions were compared with the experimental observations. A recently developed DEM contact model for cohesive solids, an Elasto-Plastic Adhesive model, was used. This particle contact model uses hysteretic non-linear loading and unloading paths and an adhesion parameter which is a function of the maximum contact overlap. The model parameters for the simulations are phenomenologically based to reproduce the key bulk characteristics exhibited by the solid. The simulation results show a good agreement in capturing the stress history dependent behaviour depicted by the flow function of the cohesive iron ore fines while also providing a reasonably good match for the lateral pressure ratio observed during the confined compression K0 tests. This demonstrates the potential for the DEM model to be used in the simulation of bulk handling applications.

Mental Health Nurses' Family Focused Practice with Parents who have Mental Illness, their Children and Families in Adult Mental Health Services in Ireland

Introduction: While it is recommended that mental health professionals engage in family focused practice (FFP), there is limited understanding regarding psychiatric nurses’ practice with parents who have mental illness, their children and families in adult mental health services.

Methods: This study utilized a mixed methods approach to measure the extent of psychiatric nurses’ family focused practice and factors that predicted it. It also sought to explore the nature and scope of high scoring psychiatric nurses’ FFP and factors that affected their capacity to engage in FFP. Three hundred and forty three psychiatric nurses in 12 mental health services throughout Ireland completed the Family Focused Mental Health Practice Questionnaire (FFMHPQ). Fourteen nurses who achieved high scores on the FFMHPQ also participated in semi-structured interviews.

Results: Whilst the majority of nurses were not family focused a substantial minority were. High scoring nurses’ practice was complex and multifaceted, comprising various family focused activities, principles and processes. Nurses’ capacity to engage in FFP was determined by their knowledge and skills, working in community settings and own parenting experience.

Conclusions: Generally, low levels of family focused practice suggest the need for organizations to develop and implement guidelines, policies and training to support mental health professionals to adopt a whole family approach.

Avaliação de websites segundo as heurísticas de Nielsen : uma prática de ensino com alunos do ensino profissional

Relatório da prática de ensino supervisionada, Mestrado em Ensino de Informática, Universidade de Lisboa, Instituto de Educação, 2014

Identity, Well-being and Effectiveness: the Emotional Contexts of Teaching

This paper draws on findings from a four‐year longitudinal research project, commissioned by the Department for Education and Skills (DfES), which investigated Variations in Teachers’ Work, Lives and Effectiveness (VITAE). Drawing on data gathered from 300 teachers working in 100 primary and secondary schools in England, the research identified associations between commitment and effectiveness (perceived and in terms of pupil attainment) and found that there were more, and less, effective teachers in each of six professional life phases. It found that teachers in each of these phases experienced a number of different scenarios that challenged their abilities to sustain their commitment (i.e. remain resilient). This paper discusses how these impact, positively and negatively, on teachers’ capacities for sustaining their initial commitment and associations between identity, well‐being and effectiveness. It finds that teacher identities are neither intrinsically stable nor intrinsically fragmented, but that they can be more, or less, stable and more or less fragmented at different times and in different ways according to the influence of the interaction of a number of personal, professional and situated factors. The extent to which teachers are able to and are supported in managing the scenarios they experience will determine their sense of effectiveness.

Exploring Variations in Teachers' Work, Lives and Their Effects on Pupils: Key Findings and Implications from a Longitudinal Mixed Methods Study

This article outlines the research design of a large‐scale, longitudinal research study in England intended to describe and explore variations in teachers' work, lives and their effects on pupils' educational outcomes. The study, funded by the Department for Education and Skills (DfES) and incorporated into the Teaching and Learning Research Programme (TLRP) as an ‘Associate Project’, used an innovative mixed‐methods research design to create case studies of 300 teachers in Years 2, 6 and 9. The research was conducted over three consecutive academic years and collected a wide range of data through interviews, questionnaire surveys of teachers' and pupils' views and assessment data on pupils' attainments in English and mathematics. The text summarises the main findings from the research in relation to four interconnected themes of the study: Professional Life Phases; Professional Identity; Relative Effectiveness; and Resilience and Commitment. The influence of school context, in terms of level of social disadvantage of pupil intake, is also investigated. Key findings and their implications for policy and practice are highlighted.

The Personal and Professional Selves of Teachers: Stable and Unstable Identities

In much educational literature it is recognised that the broader social conditions in which teachers live and work, and the personal and professional elements of teachers' lives, experiences, beliefs and practices are integral to one another, and that there are often tensions between these which impact to a greater or lesser extent upon teachers' sense of self or identity. If identity is a key influencing factor on teachers' sense of purpose, self‐efficacy, motivation, commitment, job satisfaction and effectiveness, then investigation of those factors which influence positively and negatively, the contexts in which these occur and the consequences for practice, is essential. Surprisingly, although notions of ‘self’ and personal identity are much used in educational research and theory, critical engagement with individual teachers' cognitive and emotional ‘selves’ has been relatively rare. Yet such engagement is important to all with an interest in raising and sustaining standards of teaching, particularly in centralist reform contexts which threaten to destabilise long‐held beliefs and practices. This article addresses the issue of teacher identities by drawing together research which examines the nature of the relationships between social structures and individual agency; between notions of a socially constructed, and therefore contingent and ever‐remade, ‘self’, and a ‘self’ with dispositions, attitudes and behavioural responses which are durable and relatively stable; and between cognitive and emotional identities. Drawing upon existing research literature and findings from a four‐year Department for Education and Skills funded project with 300 teachers in 100 schools which investigated variations in teachers' work and lives and their effects on pupils (VITAE), it finds that identities are neither intrinsically stable nor intrinsically fragmented, as earlier literature suggests. Rather, teacher identities may be more, or less, stable and more or less fragmented at different times and in different ways according to a number of life, career and situational factors.

Variations in the Work and Lives of Teachers: Relative and Relational Effectiveness

The VITAE project is a four‐year (2001–2005) research study, commissioned by the Department for Education and Skills, conducted with 300 teachers in 100 schools in seven local education authorities in England. The project aimed to identify factors that may affect their work and lives over time and how these factors may, in turn, impact on their teaching and subsequent pupil progress and outcomes. It combined quantitative and qualitative methods of data collection and analysis in order to define and examine notions of teachers' relational and relative effectiveness. The first part of the paper addresses the nature of effectiveness and three key themes relating to the changing contexts of teachers' work, lives and effectiveness: the challenge of reform to notions of professionalism; professional identities; changes in teachers' work and lives. The research design and early findings and their effects upon the development of the research form the second part. The final part of the paper discusses three sets of understandings which are fundamental to any consideration of teachers' work, lives and effectiveness: relative and relational effectiveness; teacher identities; teachers' life and work contexts. The research suggests that policy‐makers, school leaders and teachers themselves need to attend to these if teacher recruitment, retention and standards are to improve.

Questões sociocientíficas e o pensamento complexo : tecituras para o ensino de ciências

Tese (doutorado)—Universidade de Brasília, Faculdade de Educação, Programa de Pós-Graduação em Educação, 2016.

Literary translation and quality assessment analysis – its significance in translation training

This paper aims to highlight the role of translation quality assessment in translation training so as to develop students’ translation competence and skills to face translation problems. An analysis to assess literary translation quality is proposed before proceeding to discuss its pedagogical implementation.

Defining and Classifying Learning Outcomes: A case study

Bologne came to globalize education in higher education, creating a unified architecture that potentiates higher education and enhances the continued interconnection of the spaces of education policy in higher education in the world, in particular in Europe. The aim of this work consists in the presentation of an identification model and skills’ classification and learning outcomes, based on the official documents of the course units (syllabus and assessment components) of a course of Higher Education. We are aware that the adoption of this model by different institutions, will contribute to interoperability learning outcomes, thus enhancing the mobility of teachers and students in the EHEA (European Higher Education Area) and third countries.

TRAILER project overview: tagging, recognition and acknowledgment of informal learning experiences

The evolution of new technology and its increasing use, have for some years been making the existence of informal learning more and more transparent, especially among young and older adults in both Higher Education and workplace contexts. However, the nature of formal and non-formal, course-based, approaches to learning has made it hard to accommodate these informal processes satisfactorily, and although technology bring us near to the solution, it has not yet achieved. TRAILER project aims to address this problem by developing a tool for the management of competences and skills acquired through informal learning experiences, both from the perspective of the user and the institution or company. This paper describes the research and development main lines of this project.

Using classroom meetings to transfer conflict resolution skills /

This study examined whether daily classroom meetings resulted in the positive transfer of conflict resolution information and skills beyond the formal classroom setting and into the classroom. A control group of sixteen Grade five students received three weeks of conflict resolution training and an experimental group of nineteen Grade five students fi-om the same school received three weeks of conflict resolution training followed by three additional weeks of class meetings. Pretest measures were taken via a scaled questionnaire and short answer questions before the conflict resolution lessons began for the following skills: knowledge of conflict resolution; conflict resolution behaviour; and attitude about using conflict resolution to resolve problems with other people. Posttest measures examined conflict resolution skills following involvement in the study. Students chosen randomly and both teachers were interviewed following the study. The teachers were again interviewed three months after the study. Teacher journal notes rounded out the data. The results of the study indicated that the Grade five boys who participated in three weeks of conflict resolution training did not increase their conflict resolution skills in any of the areas examined. Girls who participated in three weeks of conflict resolution training did not improve in two areas (i.e., behaviour, knowledge) and became less positive about using verbal mediation to resolve conflicts. The Grade five students who participated in three weeks of training and three weeks of class meetings obtained different results. The boys improved significantly in their ability to use verbal mediation to resolve conflicts and were more positive about verbal mediation. They did not become more knowledgeable about verbal mediation. The girls who participated in three weeks of training and three weeks of class meetings were more knowledgeable of conflict resolution and used conflict resolution to solve problems with other people. However, they were significantly less positive about using these skills to resolve problems.