How can experience in clinical and community settings contribute to early medical education? A BEME systematic review

Review date: Review period January 1992-December 2001. Final analysis July 2004-January 2005. Background and review context: There has been no rigorous systematic review of the outcomes of early exposure to clinical and community settings in medical education. Objectives of review: (1) Identify published empirical evidence of the effects of early experience in medical education, analyse it, and synthesize conclusions from it. (2) Identify the strengths and limitations of the research effort to date, and identify objectives for future research. Search strategy: Ovid search of. BEI, ERIC, Medline, CIATAHL and EMBASE Additional electronic searches of: Psychinfo, Timelit, EBM reviews, SIGLE, and the Cochrane databases. Hand-searches of: Medical Education, Medical Teacher, Academic Medicine, Teaching and Learning in Medicine, Advances in Health Sciences Education, Journal of Educational Psychology. Criteria: Definitions: Experience: Authentic (real as opposed to simulated) human contact in a social or clinical context that enhances learning of health, illness and/or disease, and the role of the health professional. Early: What would traditionally have been regarded as the preclinical phase, usually the first 2 years. Inclusions: All empirical studies (verifiable, observational data) of early experience in the basic education of health professionals, whatever their design or methodology, including papers not in English. Evidence from other health care professions that could be applied to medicine was included. Exclusions: Not empirical; not early; post-basic; simulated rather than 'authentic' experience. Data collection: Careful validation of selection processes. Coding by two reviewers onto an extensively modified version of the standard BEME coding sheet. Accumulation into an Access database. Secondary coding and synthesis of an interpretation. Headline results: A total of 73 studies met the selection criteria and yielded 277 educational outcomes; 116 of those outcomes (from 38 studies) were rated strong and important enough to include in a narrative synthesis of results; 76% of those outcomes were from descriptive studies and 24% from comparative studies. Early experience motivated and satisfied students of the health professions and helped them acclimatize to clinical environments, develop professionally, interact with patients with more confidence and less stress, develop self-reflection and appraisal skill, and develop a professional identity. It strengthened their learning and made it more real and relevant to clinical practice. It helped students learn about the structure and function of the healthcare system, and about preventive care and the role of health professionals. It supported the learning of both biomedical and behavioural/social sciences and helped students acquire communication and basic clinical skills. There were outcomes for beneficiaries other than students, including teachers, patients, populations, organizations and specialties. Early experience increased recruitment to primary care/rural medical practice, though mainly in US studies which introduced it for that specific purpose as part of a complex intervention. Conclusions: Early experience helps medical students socialize to their chosen profession. It. helps them acquire a range of subject matter and makes their learning more real and relevant. It has potential benefits for other stakeholders, notably teachers and patients. It can influence career choices.

The judicious utilization of new technologies through authentic learning in higher education: A case study

Though technology holds significant promise for enhanced teaching and learning it is unlikely to meet this promise without a principled approach to course design. There is burgeoning discourse about the use of technological tools and models in higher education, but much of the discussion is fixed upon distance learning or technology based courses. This paper will develop and propose a balanced model for effective teaching and learning for “on campus” higher education, with particular emphasis on the opportunities for revitalisation available through the judicious utilisation of new technologies. It will explore the opportunities available for the creation of more authentic learning environments through the principled design. Finally it will demonstrate with a case study how these have come together enabling the creation of an effective and authentic learning environment for one pre-service teacher education course at the University of Queensland.

Coherence and understanding in informal conversations between native and non-native speakers of English

This study investigates informal conversations between native English speakers and international students living and studying in the UK. 10 NNS participants recorded themselves during conversations with native speakers. The audio-recordings were transcribed and a fine-grained, qualitative analysis was employed to examine how the participants jointly achieved both coherence and understanding in the conversations, and more specifically how the NNSs contributed to this achievement. The key areas of investigation focused on features of topic management, such as topic initiations, changes and transitions, and on the impact which any communicative difficulties may have on the topical continuity of the conversations. The data suggested that these conversations flowed freely and coherently, and were marked by a relative scarcity of the communicative difficulties often associated with NS-NNS interactions. Moreover, language difficulties were found to have minimal impact on the topic development of the conversations. Unlike most previous research in the field, the data further indicated that the NNSs were able to make active contributions to the initiation and change of topics, and to employ a range of strategies to manage these effectively and coherently. The study considers the implications which the findings may have for teaching and learning, for second language acquisition research, and for non-native speakers everywhere.

Resisting the final word:challenging stale media and policy representations of students’ performative technological encounters in university education

This article explores powerful, constraining representations of encounters between digital technologies and the bodies of students and teachers, using corpus-based Critical Discourse Analysis (CDA). It discusses examples from a corpus of UK Higher Education (HE) policy documents, and considers how confronting such documents may strengthen arguments from educators against narrow representations of an automatically enhanced learning. Examples reveal that a promise of enhanced ‘student experience’ through information and communication technologies internalizes the ideological constructs of technology and policy makers, to reinforce a primary logic of exchange value. The identified dominant discursive patterns are closely linked to the Californian ideology. By exposing these texts, they provide a form of ‘linguistic resistance’ for educators to disrupt powerful processes that serve the interests of a neoliberal social imaginary. To mine this current crisis of education, the authors introduce productive links between a Networked Learning approach and a posthumanist perspective. The Networked Learning approach emphasises conscious choices between political alternatives, which in turn could help us reconsider ways we write about digital technologies in policy. Then, based on the works of Haraway, Hayles, and Wark, a posthumanist perspective places human digital learning encounters at the juncture of non-humans and politics. Connections between the Networked Learning approach and the posthumanist perspective are necessary in order to replace a discourse of (mis)representations with a more performative view towards the digital human body, which then becomes situated at the centre of teaching and learning. In practice, however, establishing these connections is much more complex than resorting to the typically straightforward common sense discourse encountered in the Critical Discourse Analysis, and this may yet limit practical applications of this research in policy making.

On the possible implementation of nondirective teaching for English class in post secondary public schools in China

The paper explores how Chinese English teachers assume appropriate roles in applying nondirective teaching model to classrooms. After reviewing the current situation of English teaching and learning in China, it introduces the nondirective teaching model and its characteristics. Then, it focuses on the implementation of nondirective teaching model at the public schools in China. Finally it discusses the essential role that nondirective teaching model plays in helping students become powerful learners on English learning.

Who is in charge? An L2 Discourse Intonation Study on Four Prosodic Parameters to Exert the Pragmatic Function of Dominance and Control in the Context of L2 Non-specialist Public Speaking

This paper reports the findings from a study of the learning of English intonation by Spanish speakers within the discourse mode of L2 oral presentation. The purpose of this experiment is, firstly, to compare four prosodic parameters before and after an L2 discourse intonation training programme and, secondly, to confirm whether subjects, after the aforementioned L2 discourse intonation training, are able to match the form of these four prosodic parameters to the discourse-pragmatic function of dominance and control. The study designed the instructions and tasks to create the oral and written corpora and Brazil’s Pronunciation for Advanced Learners of English was adapted for the pedagogical aims of the present study. The learners’ pre- and post-tasks were acoustically analysed and a pre / post- questionnaire design was applied to interpret the acoustic analysis. Results indicate most of the subjects acquired a wider choice of the four prosodic parameters partly due to the prosodically-annotated transcripts that were developed throughout the L2 discourse intonation course. Conversely, qualitative and quantitative data reveal most subjects failed to match the forms to their appropriate pragmatic functions to express dominance and control in an L2 oral presentation.

From Kandinsky to Java (The Use of 20th Century Abstract Art in Learning Programming)

At the University of Worcester we are continually striving to find new approaches to the learning and teaching of programming, to improve the quality of learning and the student experience. Over the past three years we have used the contexts of robotics, computer games, and most recently a study of Abstract Art to this end. This paper discusses our motivation for using Abstract Art as a context, details our principles and methodology, and reports on an evaluation of the student experience. Our basic tenet is that one can view the works of artists such as Kandinsky, Klee and Malevich as Object-Oriented (OO) constructions. Discussion of these works can therefore be used to introduce OO principles, to explore the meaning of classes, methods and attributes and finally to synthesize new works of art through Java code. This research has been conducted during delivery of an “Advanced OOP (Java)” programming module at final-year Undergraduate level, and during a Masters’ OO-Programming (Java) module. This allows a comparative evaluation of novice and experienced programmers’ learning. In this paper, we identify several instructional factors which emerge from our approach, and reflect upon the associated pedagogy. A Catalogue of ArtApplets is provided at the associated web-site.

Student attitudes towards cooperative learning in education

Abstract: Active or participatory learning by the student within a classroom environment has been fairly recently recognized as an effective, efficient, and superior instructional technique yet few teachers in higher education have adopted this pedagogical strategy. This is especially true in Science where teachers primarily lecture to passively seated students while using static visual aids or multimedia projections. Teachers generally teach as they were taught and lecture formats have been the norm. Although student-learning theories as well as student learning styles, abilities, and understanding strategies have changed, traditional teaching techniques have not evolved past the “chalk and talk” instructional strategy. This research looked into student’s perceptions of cooperative learning or team-based active learning in order to gain insight and some understanding as to how students felt about this learning technique. Student’s attitudes were then compared to student grades to detennine whether cooperative learning impeded or ameliorated academic performance. The results revealed significant differences measured in all the survey questions pertaining to perception or attitudes. As a result of the cooperative learning activities, respondents indicated more agreement to the survey questions pertaining to the benefits of cooperative learning. The experimental group exposed to cooperative learning thus experienced more positive attitudes and perceptions than the groups exposed only to a lecture-based teaching and learning format. Each of the hypotheses tested demonstrated that students had more positive attitudes towards cooperative learning strategies. Recommendations as to future work were presented in order to gain a greater understanding into both student and teacher attitudes towards the cooperative learning model.||Résumé: Lapprentissage actif ou préparatoire par létudiant au sein d’une classe a été reconnu assez récemment comme une technique d’enseignement plus efficace. Cependant, peu d’enseignants ont adopté cette stratégie pedagogique pour l'éducation post-secondaire. Ceci est particulièrement le cas dans le domaine des sciences où les enseignants font surtout usage de cours magistraux avec des étudiants passifs tout en utilisant des aides visuelles statiques ou des projections multimédias. Les professeurs enseignent generalement comme on leur a eux-même enseigné et les cours magistraux ont été la norme par le passé. Les techniques traditionnelles d'enseignernent n'ont pas évolué au-delà de la craie et du tableau noir et ce même si les théories sur l’apprentissage par les étudiants ont changé, tout comme les styles, les habiletés et les stratégies de compréhension d’apprentissage des étudiants. Cette recherche se penche sur les perceptions des étudiants au sujet de l'apprentissage coopératif ou de l'apprentissage actif par équipe de telle sorte qu'on puisse avoir un aperçu et une certaine compréhension de comment les étudiants se sentent par rapport à ces techniques d'apprentissage. Les attitudes des étudiants ont par la suite été comparées aux notes de ceux-ci pour déterminer si l'apprentissage coopératif avait nui ou au contraire amélioré leurs performances académiques. Les résultats obtenus dans l'étude d'ensemble révèlent des différences significatives dans toutes les questions ayant trait à la perception et aux attitudes.

Recent educational changes at higher educational level in Pakistan: English language teachers' perceptions and practices

Higher Education Institutes (HEIs) of any country could be a source of providing professionals to the country in many fields. By doing so, HEIs could play a pivotal role in the economic growth of the country. In Pakistan, it seems that, in the wake of this realization, steps have been taken to reform Higher Education. Drawing on the Triple I model of educational change covering Initiation, Implementation and Institutionalization (Fullan, 2007) this study focuses on the planning and implementation of reforms in the Education system of Pakistan at higher education level that have been introduced by the Higher Education Commission (HEC) since its inception in 2002. Kennedy’s model of hierarchical subsystems affecting innovation and Chin and Benne’s (1985) description of strategies for implementing change also provided guidelines for analyzing the changes in education in the country to highlight the role that the authorities expect the language teacher to play in the process of implementing these changes. A qualitative method is followed in this study to gather data from English language teachers at three universities of the Khyber Pakhtunkhwa province of Pakistan. A questionnaire was developed to look into the perceptions of English language teachers regarding the impact of these reforms. This was followed up by interviews. Responses from 28 teachers were received through questionnaire out of which 9 teachers were interviewed for detailed analysis of their perceptions. Thematic Content analysis was used to analyze and interpret the data. Some of the most significant changes that the respondents reported knowledge of included the introduction of Semester System, extending the Bachelors degree to four years from two years, promotion of research culture, and increased teachers’ autonomy in classroom practices. Implications of these reforms for English teachers’ professional development were also explored. The data indicate that the teachers generally have a positive attitude towards the changes. However, the data also show concerns that teachers have about the practical effectiveness of these changes in improving English language teaching and learning in Pakistani Universities. Some of the areas of concern are worries regarding resources, the assessment system, the number of qualified teachers, and instability in the educational policy. They are concerned about the training facilities and quality of the professional training available to them. Moreover, they report that training opportunities for their professional development are not available to all the teachers equally. Despite the HEC claims of providing regular training opportunities, the majority of the teachers did not receive any formal training in the last three years, while some teachers were able to access these opportunities multiple times. Through the recent reforms HEC has empowered the teachers in conducting the learning/teacher processes but this extra power has reduced their accountability and they can exercise these powers without any check on them. This empowerment is limited to the classroom and there appears to be no or minimal involvement in decision making at the top level of policy making. Such lack of involvement in the policy decisions seems to be generating a lack of sense of ownership among the teachers (Fullan 2003a:6). Although Quality Enhancement Cells have been developed in the universities to assure the desired quality of education, they might need a more active role to contribute in achieving the level of enhancement in education expected from them. Based on the perceptions of the respondents of this study and the review of the relevant literature, it is argued that it is unlikely for the reforms to be institutionalized if teachers are not given the right kind of awareness at the initiation stage and are not prepared at the implementation stage to cope with the challenge of a complex process. The teachers participating in this study, in general, have positive and enthusiastic attitudes towards most of the changes, in spite of some reservations. It could also be interesting to see if the power centers of the Pakistani Higher Education appreciate this enthusiasm and channel it for a strong Higher Education system in the country.

Towards an understanding of Pakistani undergraduates’ current attitudes towards learning and speaking English

The English language has an important place in Pakistan and in its education system, not least because of the global status of English and its role in employment. Realising the need to enhance language learning outcomes, especially at the tertiary level, the Higher Education Commission (HEC) of Pakistan has put in place some important measures to improve the quality of English language teaching practice through its English Language Teaching Reforms (ELTR) project. However, there is a complex linguistic, educational and ethnic diversity in Pakistan and that diversity, alongside the historical and current role of English in the country, makes any language teaching reform particularly challenging. I argue, in this thesis, that reform to date has largely ignored the issues of learner readiness to learn and learner perceptions of the use of English. I argue that studying learner attitudes is important if we are to understand how learners perceive the practice of learning and the use of English in their lives. This study focuses on the attitudes of undergraduate learners of English as a foreign language at two universities in the provinces of Sindh and Balochistan in Pakistan. These provinces have experienced long struggles and movements related to linguistic and ethnic rights and both educate students from all of the districts of their respective provinces. Drawing on debates around linguistic imperialism, economic necessity, and linguistic and educational diversity, I focus on learners’ perceptions about learning and speaking English, asking what their attitudes are towards learning and speaking English with particular reference to socio-psychological factors at a given time and context, including perceived threats to their culture, religion, and mother tongue. I ask how they make choices about learning and speaking English in different domains of language use and question their motivation to learn and speak English. Additionally, I explore issues of anxiety with reference to their use of English. Following a predominantly qualitative mixed methods research approach, the study employs two research tools: an adapted Likert Scale questionnaire completed by 300 students and semi-structured interviews with 20 participants from the two universities. The data were analysed through descriptive statistics and qualitative content analysis, with each set of data synthesised for interpretation. The findings suggest that, compared with the past, the majority of participants hold positive attitudes towards learning and speaking English regardless of their ethnic or linguistic backgrounds. Most of these undergraduate students do not perceive the use of English as a threat to their culture, mother tongue or religious values but, instead, they have a pragmatic and, at the same time, aspirational attitude to the learning and use of English. I present these results and conclude this thesis with reference to ways in which this small-scale study contributes to a better understanding of learner attitudes and perceptions. Acknowledging the limitations of this study, I suggest ways in which the study, enhanced and extended by further research, might have implications for practice, theory and policy in English language teaching and learning in Pakistan.

School engagement and burnout in a sample of brazilian students

Objective: Some studies have suggested that school engagement can be an ally in the prevention of psychosocial and occupational risks, to which students are exposed daily. The aim of this study is to estimate the impact of emotional, behavioral, and cognitive engagement on burnout syndrome among pharmacy undergraduate students. Methods: A total of 363 students enrolled in the pharmacy undergraduate program in the College of Pharmaceutical Sciences at Sao Paulo State University’s Araraquara Campus (UNESP) participated, 78.0% of whom were female. Mean age was 20.3 (SD = 2.7) years. The Maslach Burnout Inventory for students (MBI-SS) and the University Students School Engagement Inventory (USEI) were used. Confirmatory factor analysis was performed to assess the psychometric properties of the instruments. The data were included in a structural equation model in which burnout was considered the central construct. The impact of school engagement on burnout was based on the statistical significance of causal paths (β) evaluated by z tests (α = 5%). Results: The psychometric properties of the MBI-SS and USEI were adequate and the structural model also presented an adequate fit. Behavioral engagement (β = −0.56) and the emotional engagement (β = −0.71) explained 81.0% of burnout variability in the sample. Cognitive engagement was not found to contribute significantly. This data provides evidence of the impact of school engagement on burnout that can be used by educators and policymakers in charge of educational process. Conclusion: School engagement presented inverse and significant influence on burnout syndrome among pharmacy students.

A literary approach to teaching english language in a multicultural classroom

Literature is not generally considered as a coherent branch of the curriculum in relation to language development in either native or foreign language teaching. As teachers of English in multicultural Indian classrooms, we come across students with varying degrees of competence in English language learning. Although language learning is a natural process for natives, students of other languages put in colossal efforts to learn it. Despite their sincere efforts, they face challenges regarding pronunciation, spelling, and vocabulary. Indian classrooms are a microcosm of the larger society, so teaching English language in a manner that equips the students to face the cutthroat competition has become a necessity and a challenge for English language teachers. English today has become the key determinant for being successful in their careers. The hackneyed and stereotypical methods of teaching are not acceptable now. Teachers are no longer arbitrary dispensers of knowledge, but they are playing the role of a guide and facilitator for the students. Teachers of English are using innovative ideas to make English language teaching and learning interesting and simple. Teachers have started using literary texts and their analyses to explore and ignite the imagination and creative skills of the students. One needs to think and rethink the contribution of literature to intelligent thinking as well as its role in the process of teaching/learning. This article is, therefore, an attempt at exploring the nature of the literary experience in the present-day classrooms and the broader role of literature in life.

Best-practice model for technology enhanced learning in the creative arts

This paper presents a best-practice model for the redesign of virtual learning environments (VLEs) within creative arts to augment blended learning. In considering a blended learning best-practice model, three factors should be considered: the conscious and active human intervention, good learning design and pedagogical input, and the sensitive handling of the process by trained professionals. This study is based on a comprehensive VLE content analysis conducted across two academic schools within the creative arts at one Post-92 higher education (HE) institution. It was found that four main barriers affect the use of the VLE within creative arts: lack of flexibility in relation to navigation and interface, time in developing resources, competency level of tutors (confidence in developing online resources balanced against other flexible open resources) and factors affecting the engagement of ‘digital residents’. The experimental approach adopted in this study involved a partnership between the learning technology advisor and academic staff, which resulted in a VLE best-practice model that focused directly on improving aesthetics and navigation. The approach adopted in this study allowed a purposive sample of academic staff to engage as participants, stepping back cognitively from their routine practices in relation to their use of the VLE and questioning approaches to how they embed the VLE to support teaching and learning. The model presented in this paper identified a potential solution to overcome the challenges of integrating the VLE within creative arts. The findings of this study demonstrate positive impact on staff and student experience and provide a sustainable model of good practice for the redesign of the VLE within creative disciplines.