How to progress from discourse to practice? a new agenda for change in medical schools into the next decade

In the context of medical school instruction, the segmented approach of a focus on specialties and excessive use of technology seem to hamper the development of the professional-patient relationship and an understanding of the ethics of this relationship. The real world presents complexities that require multiple approaches. Engagement in the community where health competence is developed allows extending the usefulness of what is learned. Health services are spaces where the relationship between theory and practice in health care are real and where the social role of the university can be revealed. Yet some competencies are still lacking and may require an explicit agenda to enact. Ten topics are presented for focus here: environmental awareness, involvement of students in medical school, social networks, interprofessional learning, new technologies for the management of care, virtual reality, working with errors, training in management for results, concept of leadership, and internationalization of schools. Potential barriers to this agenda are an underinvestment in ambulatory care infrastructure and community-based health care facilities, as well as in information technology offered at these facilities; an inflexible departmental culture; and an environment centered on a discipline-based medical curriculum.

Building Leadership: The Knowledge of Principals in Creating Collaborative Communities of Professional Learning

Research literature is replete with the importance of collaboration in schools, the lack of its implementation, the centrality of the role of the principal, and the existence of a gap between knowledge and practice--or a "Knowing-Doing Gap." In other words, there is a set of knowledge that principals must know in order to create a collaborative workplace environment for teachers. This study sought to describe what high school principals know about creating such a culture of collaboration. The researcher combed journal articles, studies and professional literature in order to identify what principals must know in order to create a culture of collaboration. The result was ten elements of principal knowledge: Staff involvement in important decisions, Charismatic leadership not being necessary for success, Effective elements of teacher teams, Administrator‘s modeling professional learning, The allocation of resources, Staff meetings focused on student learning, Elements of continuous improvement, and Principles of Adult Learning, Student Learning and Change. From these ten elements, the researcher developed a web-based survey intended to measure nine of those elements (Charismatic leadership was excluded). Principals of accredited high schools in the state of Nebraska were invited to participate in this survey, as high schools are well-known for the isolation that teachers experience--particularly as a result of departmentalization. The results indicate that principals have knowledge of eight of the nine measured elements. The one that they lacked an understanding of was Principles of Student Learning. Given these two findings of what principals do and do not know, the researcher recommends that professional organizations, intermediate service agencies and district-level support staff engage in systematic and systemic initiatives to increase the knowledge of principals in the element of lacking knowledge. Further, given that eight of the nine elements are understood by principals, it would be wise to examine reasons for the implementation gap (Knowing-Doing Gap) and how to overcome it.

Discourse and Cooperative Learning in the Math Classroom

In this action research study of my 6th grade math classroom I investigated the effects of increased student discourse and cooperative learning on the students’ ability to explain and understand math concepts and problem solving, as well as its effects on their use of vocabulary and written explanations. I also investigated how it affected students’ attitudes. I discovered that increased student discourse and cooperative learning resulted in positive changes in students’ attitudes about their ability to explain and understand math, as well as their actual ability to explain and understand math concepts. Evidence in regard to use of vocabulary and written explanations generally showed little change, but this may have been related to insufficient data. As a result of this research, I plan to continue to use cooperative learning groups and increased student discourse as a teaching practice in all of my math classes. I also plan to include training on cooperative learning strategies as well as more emphasis on vocabulary and writing in my math classroom.

Availability and Use of Audiovisual and Electronic Resources by Distance Learning Students in Nigerian Universities: a Case Study of National Open University of Nigeria (NOUN), Ibadan Study Centre

This study investigated the availability and use of audiovisual and electronic resources by distance learning students at the National Open University of Nigeria (NOUN). A questionnaire was administered tothe distance learning students selected across the various departments of the NOUN. The findings revealed that even though NOUN made provision for audiovisual and electronic resources for students' use, a majority of the audiovisual and electronic resources are available through personal provision by the students.The study also revealed regular use of audiovisual and electronic resources by the distance learning students. Constraints on use include poor power supply, poor infrastructure, lack of adequate skill, and high cost of access.

Improving Student Engagement and Verbal Behavior Through Cooperative Learning

In this action research study of my classroom of 10th grade Algebra II students, I investigated three related areas. First, I looked at how heterogeneous cooperative groups, where students in the group are responsible to present material, increase the number of students on task and the time on task when compared to individual practice. I noticed that their time on task might have been about the same, but they were communicating with each other mathematically. The second area I examined was the effect heterogeneous cooperative groups had on the teacher’s and the students’ verbal and nonverbal problem solving skills and understanding when compared to individual practice. At the end of the action research, students were questioning each other, and the instructor was answering questions only when the entire group had a question. The third area of data collection focused on what effect heterogeneous cooperative groups had on students’ listening skills when compared to individual practice. In the research I implemented individual quizzes and individual presentations. Both of these had a positive effect on listing in the groups. As a result of this research, I plan to continue implementing the round robin style of in- class practice with heterogeneous grouping and randomly selected individual presentations. For individual accountability I will continue the practice of individual quizzes one to two times a week.

Improving Student Engagement and Verbal Behavior Through Cooperative Learning

In this action research study of my classroom of 10th grade Algebra II students, I investigated three related areas. First, I looked at how heterogeneous cooperative groups, where students in the group are responsible to present material, increase the number of students on task and the time on task when compared to individual practice. I noticed that their time on task might have been about the same, but they were communicating with each other mathematically. The second area I examined was the effect heterogeneous cooperative groups had on the teacher’s and the students’ verbal and nonverbal problem solving skills and understanding when compared to individual practice. At the end of the action research, students were questioning each other, and the instructor was answering questions only when the entire group had a question. The third area of data collection focused on what effect heterogeneous cooperative groups had on students’ listening skills when compared to individual practice. In the research I implemented individual quizzes and individual presentations. Both of these had a positive effect on listing in the groups. As a result of this research, I plan to continue implementing the round robin style of in- class practice with heterogeneous grouping and randomly selected individual presentations. For individual accountability I will continue the practice of individual quizzes one to two times a week.

Meaningful Independent Practice in Mathematics

In this action research of my seventh grade mathematics classroom, I investigated how students’ explanations of math homework would improve their learning in math. I discovered these explanations can be very beneficial in helping students to improve their understanding of current skills although it did not affect all students. As a result of this study, I plan to incorporate these student explanations in my instruction next year but not as a daily expectation.

Applying validated quality indicators to surgical antibiotic prophylaxis in a Brazilian hospital: Learning what should be learned

Background: Compliance with the best surgical antibiotic prophylaxis practice is usually low despite many published guidelines. Objective: This study investigated compliance with the Hospital Infection Control Committee guideline for antibiotic prophylaxis in a Brazilian hospital using quality indicators. Methods: A retrospective study was carried out from November 2009 to March 2010. Medical records from adult inpatients undergoing cardiac, neurologic, and orthopedic clean surgeries were included. The full compliance index was considered 100% when the antibiotic prophylaxis showed adequacy in all evaluated attributes. Analyses were conducted with 5% significance. Results: Medical records from 101 cardiac, 128 neurologic, and 519 orthopedic surgical patients were evaluated. The compliance index was 4.9%, and the compliance index according to specialty was 5.8%, 3.1%, and 3.0%, respectively, for orthopedic, neurologic, and cardiac surgeries. The attribute route of administration produced the best outcomes, whereas the attribute duration of antibiotic prophylaxis produced the worst. No association was identified between compliance to the attributes and patient characteristics. Conclusion: This study showed a low level of adherence to Hospital Infection Control Committee guidelines for antibiotic prophylaxis. This suggests that different strategies should be implemented to promote the best possible practice in the field of antibiotic prophylaxis with greater surgeon engagement. Copyright (C) 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

PBL and B-Learning for Civil Engineering Students in a Transportation Course

The results of a pedagogical strategy implemented at the University of Sao Paulo at Sao Carlos are presented and discussed. The initiative was conducted in a transportation course offered to Civil Engineering students. The approach is a combination of problem-based learning and project-based learning (PBL) and blended-learning (B-learning). Starting in 2006, a different problem was introduced every year. From 2009 on, however, the problem-based learning concept was expanded to project-based learning. The performance of the students was analyzed using the following elements: (1) grades in course activities; (2) answers from a questionnaire designed for course evaluation; and (3) cognitive maps made to assess the effects of PBL through the comparison of the responses provided by the students involved and those not involved in the experiment. The results showed positive aspects of the method, such as a strong involvement of several students with the subject. A gradual increase in the average scores obtained by the students in the project activities (from 6.77 in 2006 to 8.24 in 2009) was concomitant with a better evaluation of these activities and of the course as a whole (90 and 97% of options "Good" or "Very good" in 2009, respectively). A growing interest in the field of transportation engineering as an alternative for further studies was also noticed. DOI: 10.1061/(ASCE)EI.1943-5541.0000115. (C) 2012 American Society of Civil Engineers.

Central catheter dressing in a simulator: the effects of tutor's assistance or self-learning tutorial

Aims: to compare the performance of undergraduate students concerning semi-implanted central venous catheter dressing in a simulator, with the assistance of a tutor or of a self-learning tutorial. Method: Randomized controlled trial. The sample consisted of 35 undergraduate nursing students, who were divided into two groups after attending an open dialogue presentation class and watching a video. One group undertook the procedure practice with a tutor and the other with the assistance of a self-learning tutorial. Results: in relation to cognitive knowledge, the two groups had lower performance in the pre-test than in the post-test. The group that received assistance from a tutor performed better in the practical assessment. Conclusion: the simulation undertaken with the assistance of a tutor showed to be the most effective learning strategy when compared to the simulation using a self-learning tutorial. Advances in nursing simulation technology are of upmost importance and the role of the tutor in the learning process should be highlighted, taking into consideration the role this professional plays in knowledge acquisition and in the development of critical-reflexive thoughts and attitudes. (ClinicalTrials.gov Identifier: NCT 01614314).

Best practice: streaming server for educational videos at Universities

[EN]In this paper we present a video streaming solution. It describes the functionality of streaming server at our university and the workflow to embed videos into the learning platform Moodle. By the server-side role management teachers can get access to upload their recorded lectures to the server. Videos will be converted into different streaming formats and embed into the learning platform with provided embed code. The number of teachers who use this proposal is continuously growing at our university. Beside the lecture scripts the videos watched often by the students what the numbers of video accesses in the Moodle course and the streaming server traffic significantly show.

Next-state comfort in learning a vertical stick transportation sequence

Over the last decade, the end-state comfort effect (e.g., Rosenbaum et al., 2006) has received a considerable amount of attention. However, some of the underlying mechanisms are still to be investigated, amongst others, how sequential planning affects end-state comfort and how this effect develops over learning. In a two-step sequencing task, e.g., postural comfort can be planned on the intermediate position (next state) or on the actual end position (final state). It might be hypothesized that, in initial acquisition, next state’s comfort is crucial for action planning but that, in the course of learning, final state’s comfort is taken more and more into account. To test this hypothesis, a variant of Rosenbaum’s vertical stick transportation task was used. Participants (N = 16, right-handed) received extensive practice on a two-step transportation task (10,000 trials over 12 sessions). From the initial position on the middle stair of a staircase in front of the participant, the stick had to be transported either 20 cm upwards and then 40 cm downwards or 20 cm downwards and then 40 cm upwards (N = 8 per subgroup). Participants were supposed to produce fluid movements without changing grasp. In the pre- and posttest, participants were tested on both two-step sequencing tasks as well as on 20 cm single-step upwards and downwards movements (10 trials per condition). For the test trials, grasp height was calculated kinematographically. In the pretest, large end/next/final-state comfort effects for single-step transportation tasks and large next-state comfort effects for sequenced tasks were found. However, no change in grasp height from pre- to posttest could be revealed. Results show that, in vertical stick transportation sequences, the final state is not taken into account when planning grasp height. Instead, action planning seems to be solely based on aspects of the next action goal that is to be reached.

Different Learning Curves for Axillary Brachial Plexus Block: Ultrasound Guidance versus Nerve Stimulation

Little is known about the learning of the skills needed to perform ultrasound- or nerve stimulator-guided peripheral nerve blocks. The aim of this study was to compare the learning curves of residents trained in ultrasound guidance versus residents trained in nerve stimulation for axillary brachial plexus block. Ten residents with no previous experience with using ultrasound received ultrasound training and another ten residents with no previous experience with using nerve stimulation received nerve stimulation training. The novices' learning curves were generated by retrospective data analysis out of our electronic anaesthesia database. Individual success rates were pooled, and the institutional learning curve was calculated using a bootstrapping technique in combination with a Monte Carlo simulation procedure. The skills required to perform successful ultrasound-guided axillary brachial plexus block can be learnt faster and lead to a higher final success rate compared to nerve stimulator-guided axillary brachial plexus block.

Exploring the effectiveness of development research with a monitoring and learning approach

There is a growing demand for better understanding of the link between research, policy and practice in development. This article provides findings from a study that aimed to gain insights into how researchers engage with their non-academic partners. It draws on experiences from the National Centre of Competence in Research North-South programme, a development research network of Swiss, African, Asian and Latin American institutions. Conceptually, this study is concerned with research effectiveness as a means to identify knowledge useful for society. Research can be improved and adapted when monitoring the effects of interactions between researchers and non-academic partners. Therefore, a monitoring and learning approach was chosen. This study reveals researchers' strategies in engaging with non-academic partners and points to framing conditions considered decisive for soccessful interactions. It concludes that reserachrs need to systematically analyse the socio-political context in which they intervene. By providing insights from the ground and reflecting on them in the light of the latest theoretical concepts, this article contributes to the emerging literature founded on practice-based experience.

Reshaping Rural Extension: Learning for Sustainability (LforS): An Integrative and Learning-Based Advisory Approach for Rural Extension with Small-Scale Farmers

This publication offers concrete suggestions for implementing an integrative and learning-oriented approach to agricultural extension with the goal of fostering sustainable development. It targets governmental and non-governmental organisations, development agencies, and extension staff working in the field of rural development. The book looks into the conditions and trends that influence extension today, and outlines new challenges and necessary adaptations. It offers a basic reflection on the goals, the criteria for success and the form of a state-of-the-art approach to extension. The core of the book consists of a presentation of Learning for Sustainability (LforS), an example of an integrative, learning-oriented approach that is based on three crucial elements: stakeholder dialogue, knowledge management, and organizational development. Awareness raising and capacity building, social mobilization, and monitoring & evaluation are additional building blocks. The structure and organisation of the LforS approach as well as a selection of appropriate methods and tools are presented. The authors also address key aspects of developing and managing a learning-oriented extension approach. The book illustrates how LforS can be implemented by presenting two case studies, one from Madagascar and one from Mongolia. It addresses conceptual questions and at the same time it is practice-oriented. In contrast to other extension approaches, LforS does not limit its focus to production-related aspects and the development of value chains: it also addresses livelihood issues in a broad sense. With its focus on learning processes LforS seeks to create a better understanding of the links between different spheres and different levels of decision-making; it also seeks to foster integration of the different actors’ perspectives.