Finance versus costs for teaching hospitals in Spain

In this paper we analyse the observed systematic differences incosts for teaching hospitals (THhenceforth) in Spain. Concernhas been voiced regarding the existence of a bias in thefinancing of TH s has been raised once prospective budgets arein the arena for hospital finance, and claims for adjusting totake into account the legitimate extra costs of teaching onhospital expenditure are well grounded. We focus on theestimation of the impact of teaching status on average cost. Weused a version of a multiproduct hospital cost function takinginto account some relevant factors from which to derive theobserved differences. We assume that the relationship betweenthe explanatory and the dependent variables follows a flexibleform for each of the explanatory variables. We also model theunderlying covariance structure of the data. We assumed twoqualitatively different sources of variation: random effects andserial correlation. Random variation refers to both general levelvariation (through the random intercept) and the variationspecifically related to teaching status. We postulate that theimpact of the random effects is predominant over the impact ofthe serial correlation effects. The model is estimated byrestricted maximum likelihood. Our results show that costs are 9%higher (15% in the case of median costs) in teaching than innon-teaching hospitals. That is, teaching status legitimatelyexplains no more than half of the observed difference in actualcosts. The impact on costs of the teaching factor depends on thenumber of residents, with an increase of 51.11% per resident forhospitals with fewer than 204 residents (third quartile of thenumber of residents) and 41.84% for hospitals with more than 204residents. In addition, the estimated dispersion is higher amongteaching hospitals. As a result, due to the considerable observedheterogeneity, results should be interpreted with caution. From apolicy making point of view, we conclude that since a higherrelative burden for medical training is under public hospitalcommand, an explicit adjustment to the extra costs that theteaching factor imposes on hospital finance is needed, beforehospital competition for inpatient services takes place.

Enseignement de recommandations pour la pratique: la prévention et le dépistage [Teaching practice recommendations: prevention and screening].

The aim of this article is to provide guidance to family doctors on how to tutor students about effective screening and primary prevention. Family doctors know their patients and adapt national and international guidelines to their specific context, risk profile, sex and age as well as to the prevalence of the disorders under consideration. Three cases are presented to illustrate guideline use according to the level of evidence (for a 19-year-old man, a 60-year-old woman, and an 80-year-old man). A particular strength of family medicine is that doctors see their patients over the years. Thus they can progressively go through the various prevention strategies, screening, counselling and immunisation, accompanying their patients with precious advice for their health throughout their lifetime.

The Relationship between Teachers and Students in the Classroom: Communicative Language Teaching Approach and Cooperative Learning Strategy to Improve Learning

The aim of this research is to to investigate how a supportive relationship between teachers and students in the classroom can improve the learning process. By having a good relationship with students, teachers can offer to students chances to be motivated and feel engaged in the learning process. Students will be engaged actively in the learning instead of being passive learners. I wish to investigate how using communicative approach and cooperative learning strategies while teaching do affect and improve students’ learning performance. To achieve these goals qualitative data collection was used as the primary method. The results show that teachers and students value a supportive and caring relationship between them and that interaction is essential to the teacher-student relationship. This sense of caring and supporting from teachers motivates students to become a more interested learner. Students benefit and are motivated when their teachers create a safe and trustful environment. And also the methods and strategies teachers uses, makes students feel engaged and stimulated to participate in the learning process. The students have in their mind that a positive relationship with their teachers positively impacts their interest and motivation in school which contributes to the enhancement of the learning process.

Evaluation of an online, case-based interactive approach to teaching pathophysiology

Rapport de synthèse : L'article qui fait l'objet de ma thèse évalue une nouvelle approche pédagogique pour l'apprentissage de certains chapitres de physiopathologie. Le dispositif pédagogique se base sur l'alternance d'apprentissage ex-cathedra et de l'utilisation d'un site web comprenant des vignettes cliniques. Lors de la consultation de ces-dernières, l'étudiant est invité à demander des examens de laboratoire dont il pourrait justifier la pertinence selon le cas clinique étudié. La nouveauté du procédé réside dans le fait que, préalablement à son cours ex-cathedra, l'enseignant peut consulter les statistiques de demandes de laboratoire et ainsi orienter son cours selon les éléments mal compris par les étudiants. A la suite du cours ex-cathedra, les étudiants peuvent consulter sur internet la vignette clinique complète avec des explications. A l'issue de tout le cours, une évaluation auprès des étudiants a été conduite. Le procédé a été mis en place durant deux années consécutives et l'article en discute notamment les résultats. Nous avons pu conclure que cette méthode innovatrice d'enseignement amène les étudiants à mieux se préparer pour les cours ex-cathedra tout en permettant à l'enseignant d'identifier plus précisément quelles thématiques étaient difficiles pour les étudiants et donc d'ajuster au mieux son cours. Mon travail de thèse a consisté à créer ce dispositif d'apprentissage, à créer l'application web des vignettes cliniques et à l'implanter durant deux années consécutives. J'ai ensuite analysé les données des évaluations et écrit l'article que j'ai présenté à la revue 'Medical Teacher'. Après quelques corrections et précisions demandées par le comité de lecture, l'article a été accepté et publié. Ce travail a débouché sur une seconde version de l'application web qui est actuellement utilisée lors du module 3.1 de 3è année à l'Ecole de Médecine à Lausanne. Summary : Since the early days of sexual selection, our understanding of the selective forces acting on males and females during reproduction has increased remarkably. However, despite a long tradition of experimental and theoretical work in this field and relentless effort, numerous questions remain unanswered and many results are conflicting. Moreover, the interface between sexual selection and conservation biology has to date received little attention, despite existing evidence for its importance. In the present thesis, I first used an empirical approach to test various sexual selection hypotheses in a population of whitefish of central Switzerland. This precise population is characterized by a high prevalence of gonadal alterations in males. In particular, I challenged the hypothesis that whitefish males displaying peculiar gonadal features are of lower genetic quality than other seemingly normal males. Additionally, I also worked on identifying important determinant of sperm behavior. During a second theoretical part of my work, which is part of a larger project on the evolution of female mate preferences in harvested fish populations, I developed an individual-based simulation model to estimate how different mate discrimination costs affect the demographical behavior of fish populations and the evolutionary trajectories of female mate preferences. This latter work provided me with some insight on a recently published article addressing the importance of sexual selection for harvesting-induced evolution. I built upon this insight in a short perspective paper. In parallel, I let some methodological questions drive my thoughts, and wrote an essay about possible synergies between the biological, the philosophical and the statistical approach to biological questions.

Motivation and content Language Integrated Learning : an impulse for Second Language Teaching

“Estudiantes motivados producen profesores motivados y viceversa” (Lesley Denham)La cita refleja el efecto recíproco que tiene el comportamiento del profesor en el compromiso de los estudiantes a lo largo del año y viceversa. Es sorprendente como, destacando las fortalezas de cada estudiante en lugar de sus debilidades, nunca comparándolos entre ellos sino con su propio rendimiento, puede despertar una motivación intrínseca en el estudiante, y una merecida satisfacción personal para el profesor.Sin embargo, no existen botones motivacionales mágicos que podamos pulsar y hacer que el alumno quiera aprender. Como profesores, tomar la iniciativa será crucial: dar a nuestros estudiantes el espacio suficiente para experimentar, realzar su autonomía, e intuir las respuestas a través de un proceso inductivo. En definitiva, hacerles protagonistas de su proceso de aprendizaje.Incluir AICLE en la clase de inglés es una metodología que nos ayudará a conseguirlo. Los estudiantes asocian AICLE con algo interesante y divertido, diferente a las sesiones teóricas. Como resultado, al utilizar la lengua, lo hacen movidos por sus sentimientos, aprendiendo de forma implícita.“Estudiants motivats produeixen professors motivats i viceversa” (Lesley Denham)La cita reflecteix l'efecte recíproc que té el comportament del professor en el compromís dels estudiants al llarg de l'any i viceversa. És sorprenent com, destacant les fortaleses de cada estudiant en lloc de les seves debilitats, mai comparant-los entre ells sinó amb el seu propi rendiment, pot despertar una motivació intrínseca a l'estudiant, i una merescuda satisfacció personal per al professor.No obstant això, no existeixen botons motivacionals màgics que puguem prémer i fer que l'alumne vulgui aprendre. Com a professors, prendre la iniciativa serà crucial: donar als nostres estudiants l'espai suficient per experimentar, realçar la seva autonomia, i intuir les respostes a través d'un procés inductiu. En definitiva, fer-los protagonistes del seu procés d'aprenentatge.Incloure AICLE en la classe d'anglès és una metodologia que ens ajudarà a aconseguir-ho. Els estudiants consideren AICLE interessant i divertit, diferent a les sessions teòriques. Com a resultat, en utilitzar la llengua, ho fan moguts pels seus sentiments, aprenent de forma implícita.

Grinder's Group Mastery Theory : scientific research and its application to classroom teaching

Estudi centrat en el paper de la comunicació no verbal com a eina docent per a la gestió de l’aula, prenent com a referència el model de comunicació de Michael Grinder (Pentimento), basat en la Programació Neuro-lingüística (PNL). Aquest model s’analitza i es compara amb altres models i estudis sobre la comunicació no verbal, per establir-ne similituds i diferències. Per tal d’avaluar l’eficàcia de les tècniques de gestió de l’aula a través de la comunicació no verbal proposades per Grinder en un context educatiu real, s’inclouen i s’analitzen enregistraments de la implementació de diferents tècniques en un institut de secundària de Catalunya. Tota la informació recollida i analitzada permet valorar i ressaltar com és de significatiu tot allò que s’expressa més enllà del llenguatge, i per tant, com són d’importants i d’útils les habilitats comunicatives d’un professor en la seva tasca d’ensenyar.

Characterization and Application of Educational Virtual Environments for Science Teaching in Secondary School

This work describes the characteristics of a representative set of seven different virtual laboratories (VLs) aimed for science teaching in secondary school. For this purpose, a 27-item evaluation model that facilitates the characterization of the VLs was prepared. The model takes into account the gaming features, the overall usability, and also the potential to induce scientific literacy. Five of the seven VLs were then tested with two larger and highly heterogenic groups of students, and in two different contexts – biotechnology and physics, respectively. It is described how the VLs were received by the students, taking into account both their motivation and their self-reported learning outcome. In some cases, students’ approach to work with the VLs was recorded digitally, and analyzed qualitatively. In general, the students enjoyed the VL activities, and claimed that they learned from them. Yet, more investigation is required to address the effectiveness of these tools for significant learning.

Teaching evidence-based management with a focus on producing local evidence

We present an approach to teaching evidence-based management (EBMgt) that trains future managers how to produce local evidence. Local evidence is causally interpretable data, collected on-site in companies to address a specific business problem. Our teaching method is a variant of problem-based learning, a method originally developed to teach evidence-based medicine. Following this method, students learn an evidence-based problem-solving cycle for addressing actual business cases. Executing this cycle, students use and produce scientific evidence through literature searches and the design of local, experimental tests of causal hypotheses. We argue the value of teaching EBMgt with a focus on producing local evidence, how it can be taught, and what can be taught. We conclude by outlining our contribution to the literature on teaching EBMgt and by discussing limitations of our approach.